Abstract

We present a case of a 4-year-old girl with abdominal angiostrongyliasis who presented with persistent fevers, hepatosplenomegaly, acute abdominal pain, and eosinophilia. Computed tomography scan identified thickening of the ascending colon with a narrowed lumen. Endoscopic evaluation revealed ulcerations and erythema in the ascending colon. The microscopic findings in biopsies included active chronic inflammation with prominent eosinophils and granulomas. A subset of granulomas contained the eggs of Angiostrongylus costaricensis. The definitive method of diagnosing A costaricensis is histology; peripheral blood serology has low specificity and the stool from infected patients does not contain eggs or larvae. Pathologists from endemic regions (Central and South America) are familiar with the typical histologic changes; however, because of increasing global travel, all pathologists should become familiar with A costaricensis, which may mimic common gastrointestinal diseases such as Crohn’s disease, appendicitis, and Meckel’s diverticulum.

Original languageEnglish (US)
JournalInternational Journal of Surgical Pathology
DOIs
StateAccepted/In press - Dec 1 2017

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Ascending Colon
Granuloma
Crohn Disease
Eggs
Angiostrongylus
Meckel Diverticulum
Central America
South America
Gastrointestinal Diseases
Acute Pain
Eosinophilia
Appendicitis
Serology
Erythema
Eosinophils
Abdominal Pain
Larva
Histology
Fever
Tomography

Keywords

  • Angiostrongylus costaricensis
  • abdominal angiostrongyliasis
  • egg
  • eosinophilic granulomatous colitis
  • granuloma
  • inclusion

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

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title = "Abdominal Angiostrongyliasis: A Presentation of Eosinophilic Granulomatous Colitis",
abstract = "We present a case of a 4-year-old girl with abdominal angiostrongyliasis who presented with persistent fevers, hepatosplenomegaly, acute abdominal pain, and eosinophilia. Computed tomography scan identified thickening of the ascending colon with a narrowed lumen. Endoscopic evaluation revealed ulcerations and erythema in the ascending colon. The microscopic findings in biopsies included active chronic inflammation with prominent eosinophils and granulomas. A subset of granulomas contained the eggs of Angiostrongylus costaricensis. The definitive method of diagnosing A costaricensis is histology; peripheral blood serology has low specificity and the stool from infected patients does not contain eggs or larvae. Pathologists from endemic regions (Central and South America) are familiar with the typical histologic changes; however, because of increasing global travel, all pathologists should become familiar with A costaricensis, which may mimic common gastrointestinal diseases such as Crohn’s disease, appendicitis, and Meckel’s diverticulum.",
keywords = "Angiostrongylus costaricensis, abdominal angiostrongyliasis, egg, eosinophilic granulomatous colitis, granuloma, inclusion",
author = "Timothy Walls and Dominick Cavuoti and Nandini Channabasappa and Mary Yang and Paul Southern and Gill, {Michelle A.} and Park, {Jason Y.}",
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AU - Yang, Mary

AU - Southern, Paul

AU - Gill, Michelle A.

AU - Park, Jason Y.

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AB - We present a case of a 4-year-old girl with abdominal angiostrongyliasis who presented with persistent fevers, hepatosplenomegaly, acute abdominal pain, and eosinophilia. Computed tomography scan identified thickening of the ascending colon with a narrowed lumen. Endoscopic evaluation revealed ulcerations and erythema in the ascending colon. The microscopic findings in biopsies included active chronic inflammation with prominent eosinophils and granulomas. A subset of granulomas contained the eggs of Angiostrongylus costaricensis. The definitive method of diagnosing A costaricensis is histology; peripheral blood serology has low specificity and the stool from infected patients does not contain eggs or larvae. Pathologists from endemic regions (Central and South America) are familiar with the typical histologic changes; however, because of increasing global travel, all pathologists should become familiar with A costaricensis, which may mimic common gastrointestinal diseases such as Crohn’s disease, appendicitis, and Meckel’s diverticulum.

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